Help, My Penis is Bent: Diagnosing Peyronie’s Disease #urology #malesexualhealth

A reader contacted my FaceBook fan page the other day, asking if I could recommend some recourse for his bent penis. He was in his 20s and was freaking out. He was ashamed to have sex and fearful of his future. I told him it could be Peyronie’s and to get to a urologist asap.

I am not qualified to diagnose medical conditions. I also know that not all bends and bumps indicate Peyronie’s. While there is a classic “tell” in Peyronie’s — the penis gets a hard knot and a distinct bend in the shaft — only a physical exam by a medical doctor — a urologist should be your first choice — can get you an accurate diagnosis and a competent treatment plan.

While an annual visit to the gynecologist is an accepted part of women’s health, you don’t see the same emphasis on men’s health, nor do men yet understand that a visit to a urologist at the first sign of a problem could save their lives. Men are more often too embarrassed to talk about their penis with medical professionals. That means that men also ignore treatable or curable ailments until long after the problem has ruined their quality of life. Postponing visits to the urologist puts male health at risk. Piedmont Hospital in GA provides this quick guide to when and why men should see urologists.

Unfortunately, it’s a known and worrisome fact among global health workers that males often refuse to visit urologists until something goes terribly wrong. Establishing a base on testosterone levels, being checked regularly for suspicious growths (the penis, the testicles, and the prostate can all get cancer) should be part of every male’s health care routine. Every year, thousands of men dismiss early-stage cancer as an embarrassing nothing, only to get diagnosed down the road that with a lethal something. Waiting until something is killing you could, literally, kill you.

Over time, a handful of men has come to my office to reveal legitimate male sexual health problems they never discussed with anyone else only to learn that the right professional to see was a urologist, not a sex therapist. All I could do for them was give them the courage to see a medical doctor. Shame was ruining their sex lives and their mental health. They were all avoiding partnered sex, settling on masturbation or giving up on ever having a good sex life again. So sad when you know they never had to take those self-negating paths if they had headed to a trusted physician when it first started. The doctor could reassure them that they are not alone, that there are others like you, and support communities too. With a proper diagnosis, you hold the key to a successful treatment plan that can give you your life back.

Men’s failure to care for their genitals is a seldom-discussed legacy of patriarchy. It continues to haunt men who believe that masculinity means you don’t complain when something bothers you, that you accept pain as a measure of machismo, and that your so-called “junk” is actually junk, not deserving of love and acceptance. The shame that accompanies all that is psychologically devastating. Not only can it destroy relationships, it can create a cycle of self-hatred, rage, grief, and mourning when they can’t perform to their own expectations.

The normalized anti-penis attitudes we see in society play a large role in the resistence to treatment for genital problems and perceived imperfections. Not only are men ashamed to speak frankly about their genital anxieties, but they can get so anxious when something go wrong that they they feel isolated and abnormal, less than masculine, and even hopeless knowing that their penises aren’t “good enough” to deliver pleasure to a partner.

I understand how hard it is for men to turn their thinking around and learn to love the equipment they have. I know the culture is all kinds of messed up when it comes to male genitalia. And I know it’s emotionally difficult when your penis doesn’t look like other men’s penises, and even more distressing when your sex organs don’t work or feel the way they once did. But there is hope through competent medical care.

Here is a guide for those of you who have noticed a distinct curve in your beautiful penises and are not reaching out for the help that is available to you.

 

UNDERSTANDING PEYRONIE’S

Peyronie’s disease affects roughly 5-7% of adult males, or 6 out of every 100 men. It typically affects men between the ages of 30 and 70. These statistics don’t account for all the undiagnosed cases that doctors know most men hide from others and from themselves.

The risk of Peyronie’s climbs substantially after the age of 60. You may not even notice it starting. Most men hang left or right naturally, so it’s not unusual to see slight curving in a healthy penis. But there is no way to ignore full-on Peyronies.

Peyronie’s is scar tissue that forms inside the penis. It can present as a strange little (or big) lump where the penis bends or an invisible arch of scar tissue that forces the penis to bend. It can also cause the shaft to narrow into a bottleneck shape. Peyronie’s can make penetration difficult and even impossible, depending on the scar tissue and how far the disease has progressed.

The silent build-up of scar tissue can happen to all adult men. Even if you’ve never injured your penis in an accident (or recall injuring it), Peyronie’s may strike. Doctors speculate that a wide range of common experiences can build scar tissue. So, for example, it could develop after a lifetime of tucking yourself left or right, having a vigorous sex life, or repeatedly getting your penis crunched or jammed in tight pants or while playing sports. Your underlying health is not a part of it. You can be vital and strong and still fall victim to Peyronie’s.

The way Peyronie’s looks may seem bad enough but the pain can be even worse. Pain is a very personal experience in Peyronie’s. Some men claim to have little discomfort but many, if not most, feel an agonizing burning sensation in the penis almost every day, is if one side of their penis was scalded. For most men, pain reduction is their urgent priority, and that’s usually where doctors being. Doctors tend to be extremely conservative in treatment so unless the disease has progressed, they will likely medicate the pain first, then take a “wait and see” approach. Urologists typically won’t discuss surgical options until they have monitored you for a period of months after an initial diagnosis of Peyronie’s.

Based on guidelines from the Urology Health Foundation website, here are 8 signs that you may have Peyronie’s disease:

  • bent/curved penis
  • lumps in the penis
  • painful erections
  • soft erections
  • bottleneck shape to the penis
  • sexual dysfunction because of a bent/curved penis
  • shrinkage in penis size
  • unnatural (bone-like) stiffness in the shaft from calcium build-up

If you have any of these symptoms, see a urologist as soon as possible, to find out what treatment options are available to restore penis function.
HOW PEYRONIE’S HARMS QUALITY OF LIFE FOR MALES

For most men, it’s impossible to feel fully happy and complete when they experience a sexual disability — which is another way of looking at Peyronie’s. It disables your ability to feel good in bed and may make you reluctant to let other people see you naked. Meanwhile, since some Peyronie’s sufferers report high levels of penis pain, that really dampens enthusiasm for having erections, masturbating, or having partnered sex.

Medical statistics show that 75 out of 100 men with Peyronie’s disease are stressed and depressed because of it. If you look at it from a whole body/mind perspective, the stress, emotional struggle, and sex avoidance that men go through without treatment hurts more than the original problem. It’s definitely an ego-crusher when your penis isn’t working right.

Meanwhile, what price do humans pay for not having a functional sex life? For men, it means their chances of heart-attacks, strokes, stress disorders, depression and prostate cancers increase up to 60%. As medical data have repeatedly shown, frequent orgasms are life-extenders for men. Sex chemicals (when triggered) work as natural drugs against the damage caused by stress chemicals. Male orgasms flush and naturally cleanse the prostate. If Peyronie’s stops your sex life, your dead sex life may shorten your life. Simply put, orgasms are critical to a long and healthy life for males.

 

What A Urologist Can Do For You

Here is a quick summary of current medical treatment options available for Peyronie’s sufferers

If the disease gets early detection (within a year of onset), it can be resolved non-surgically. Conservative treatment options include:

Oral drugs. If your urologist recommends Vitamin E or another oral drug, get a second opinion. While oral drugs are a first option for many doctors, and might possibly work for you, the scientific opinion is that there is no strong evidence that oral drugs work at all. Consumer beware.

Injections. Yeah, I know: you hate getting a flu shot, so maybe the thought of a penis injection stops you cold. But what if those seconds of pain alleviate a lifetime of complications? I promise you that no matter how uncomfortable, the goal is worth it. I checked out The Mayo Clinic‘s drug treatment protocols and they support the Urology Health Foundation’s choice of effective drugs, as follows.

  • Collagenase is the only FDA-approved medication for Peyronie’s. It’s been used with good results on men who have “moderate to severe curvatures and a palpable nodule.” (A lump you can feel with your fingers). In addition to injecting Collagenase, the doctor may also work to unbend the shape through a technique called “modeling.”
  • Verapamil, a blood pressure medication, seems to disrupt collagen production (and potentially reduces scar tissue from Peyronie’s). It is extremely effective in pain reduction. Verapamil injections have proven effective in alleviating pain in 97% of Peyronie’s patients after 2-3 injections.
  • Interferon. Some doctors offer it. Though considered safe, and potentially helpful in reducing pain, there is no compelling evidence it significantly improves outcomes.

Surgery: As with many other diseases, early detection means prevention of more serious symptoms. If you are lucky enough to be diagnosed within 12 months of developing Peyronie’s, you may never need surgery. You may not even notice that little nodule or know what it is, but your urologist will and can address it before bad pain sets in or you need surgery.

On the other hand, if you neglect Peyronie’s, surgery may become your only option. There are three types of surgery performed by urologists: Plication, Grafting, and Penile Prosthesis. Rather than get into the gory details of what a scalpel can do for you, I’ll just note that Plication is regarded as the most effective and least risky (in terms of after-effects) procedure. You can see the University of California’s comparison chart on surgical options here: https://www.ucsfhealth.org/education/surgical_treatment_for_peyronies_disease/

 

If you think you have or someone you care about has Peyronie’s, here are some great resources for further reading on the disease and its treatment:

The National Institute of Health, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3491756/,

Medical News Today, http://www.medicalnewstoday.com/articles/242682.php

Center for Reconstructive Surgery https://www.centerforreconstructiveurology.org/peyronies-disease/surgery-plication/#.WZywsCh96Mo

Peyronie’s Society Forum, http://www.peyroniesforum.net, for support and dialogue

My Peyronie’s, a Peyronie’s patient’s site, http://www.mypeyronies.com/plication-surgery.html

 

Don’t let embarrassment destroy your quality of life. See a doctor when something looks or feels wrong between your legs, and get an annual sexual health check-up. I know you’re sexy. Keep that mojo flowing! Love your genitals, care for them as the precious parts of your body that they are, and stay sexually fit for life.